Citation Nr: 9926635
Decision Date: 09/16/99 Archive Date: 09/28/99
DOCKET NO. 98-11 489 ) DATE
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On appeal from the
Department of Veterans Affairs Regional Office in Muskogee,
Oklahoma
THE ISSUE
Entitlement to an evaluation in excess of 10 percent for a
plantar wart on the right foot.
REPRESENTATION
Appellant represented by: Disabled American Veterans
ATTORNEY FOR THE BOARD
B.N. Booher, Associate Counsel
INTRODUCTION
The veteran served on active duty from January 1942 to
November 1945. His appeal ensues from an April 1998 rating
decision of the Department of Veterans Affairs (VA) Regional
Office in Muskogee, Oklahoma.
FINDING OF FACT
The veteran's disability from removal of a plantar wart of
the right foot is currently manifested by complaints of
tenderness in the right foot, without objective evidence of
any recurrence of a plantar wart or callus.
CONCLUSION OF LAW
The criteria for an evaluation in excess of 10 percent for a
plantar wart on the right foot have not been met.
38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R.
§§ 3.321(b)(1), 4.1-4.14, 4.20, 4.71, Diagnostic Code 5299-
5279 (1998).
REASONS AND BASES FOR FINDING AND CONCLUSION
The veteran asserts that the evaluation assigned to his right
foot plantar wart disability does not reflect accurately the
severity of his symptomatology. The veteran's assertion of
an increase in the severity of his plantar wart
symptomatology is sufficient to establish a well-grounded
claim for a higher evaluation pursuant to 38 U.S.C.A. § 5107
(West 1991). Caffrey v. Brown, 6 Vet.App. 377, 381 (1994);
Proscelle v. Derwinski, 2 Vet.App. 629, 631-32 (1992).
Having examined the record in support of this claim, the
Board also finds that the VA has obtained and fully developed
all relevant evidence necessary for the equitable disposition
of the veteran's claim.
Disability evaluations are determined by evaluating the
extent to which a veteran's service-connected disability
adversely affects his ability to function under the ordinary
conditions of daily life, including employment, by comparing
his symptomatology with the criteria set forth in the
Schedule for Ratings Disabilities (rating schedule).
38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. § 4.1 (1998). If
two evaluations are potentially applicable, the higher
evaluation will be assigned if the disability picture more
nearly approximates the criteria required for that
evaluation; otherwise, the lower rating will be assigned.
38 C.F.R. § 4.7. Any reasonable doubt regarding the degree
of disability will be resolved in favor of the veteran.
38 C.F.R. § 4.3.
In the present case, the veteran developed a plantar wart on
his right foot during World War II after stepping on a stump.
Service medical records show that the veteran had the wart
removed in October 1943. Upon separation from service in
October 1945, the veteran's plantar wart continued to be
mildly symptomatic and the veteran was service connected for
the plantar wart disability in January 1948. At that time,
the RO evaluated the plantar wart disability as being 10
percent disabling. The rating has remained in effect and is
protected. See 38 C.F.R. § 3.951(b) (1998) (a disability
which has been rated at or above any evaluation of disability
for 20 years or more will not be reduced).
Post-service medical records reveal that the veteran
continued to experience symptomatology associated with the
wart. A 1987 VA examination shows that the veteran continued
to experience pain on the bottom of his foot, but he had
normal gait and no callusing. He was diagnosed with
recurrent plantar wart on the right sole. In March 1992, a
VA examiner diagnosed the veteran with "trigger point right
front sole with history of removal of plantar corn."
In a claim filed in March 1998, the veteran requested an
increased evaluation due to a history of recurrent callusing
on the right foot and pain in both feet. The RO evaluated
the veteran's right plantar wart as 10 percent disabling by
analogy to metatarsalgia under 38 C.F.R. § 4.71a, Diagnostic
Code (DC) 5299-5279. The veteran is currently receiving the
maximum benefit pursuant to DC 5279. DC 5284 provides that a
10 percent evaluation is warranted for moderate foot injuries
and a 20 percent evaluation is warranted for moderately
severe foot injuries. DC 7804 is also for consideration in
this case by analogy to a tender scar. For the reasons
stated below, the Board concludes that the veteran's plantar
wart disability does not approximate the criteria for a
rating in excess of 10 percent.
An April 1998 VA foot examination shows that the veteran
currently does not have a callus, or any other type of skin
breakdown. The veteran's feet were tender to touch on the
soles and he had difficulty walking due to Parkinson's
disease. The veteran was diagnosed with status post removal
of plantar wart and peripheral vascular disease.
A July 1998 VA examination shows that the veteran had marked
tenderness to palpation at the metatarsal heads of the second
and third metatarsals of the right foot. In the diagnostic
assessment, the examiner noted that tenderness at the right
plantar foot did not appear to be a planter wart at the
present time. The examiner noted that it was possible the
veteran had a weight bearing problem such as a neuroma. The
examiner indicated that an orthopedic or podiatric evaluation
would be required in order to determine whether the weight-
bearing problem was associated with a neuroma. The VA
examination report also reflects that upon examination of the
plantar surface of the veteran's right foot, no wart was
visualized.
The aforementioned evidence establishes that the veteran
currently has pain upon palpation of the foot. He does not
have a callus and he does not have a wart on the plantar
surface of his right foot and the tenderness was not
attributed to a plantar wart on recent examination. In any
event, the veteran is currently receiving the maximum 10
percent benefit provided under DC 7804 for a tender scar and
a rating in excess of 10 percent would not be available under
this code. This symptomatology does not warrant a 20 percent
evaluation for moderately severe foot injuries under DC 5284,
especially in the absence of any recent recurrence of a wart
or callus.
The Board also notes that the record clearly shows that the
veteran suffers from several nonservice-connected foot
disorders and the July 1998 VA examination report reflects
that the VA examiner thought that the veteran might have a
neuroma, which could be the cause of his weight-bearing
difficulty. Presently, there is no evidence of record to
show that the possible neuroma or any other foot disorder is
causally related to the veteran's service-connected plantar
wart disability. In order to show that a service-connected
disability has increased by virtue of the fact that it caused
a new disease, a claimant must provide medical evidence of
the causal relationship. See Jones v. Brown, 7 Vet.App.134
(1994). Should the veteran have medical evidence that
establishes that a neuroma, or other foot disorder is
causally related to his service-connected plantar wart
disability, he should submit the same to the RO for review
and further action.
The veteran and his representative also claim that the
veteran is entitled to an increased evaluation due to loss of
range of motion. However, the objective evidence of record
does not establish that the veteran suffers from loss of
range of motion in connection with his service-connected
plantar wart disability. The Board has also considered
whether an extra-schedular evaluation pursuant to the
provisions of 38 C.F.R. § 3.321(b)(1) is warranted. In the
present case, however, the veteran is retired after working
for many years in a glass factory and as a rancher. There
has been no assertion or showing that the plantar wart
disability has necessitated frequent periods of
hospitalization or otherwise renders impracticable the
application of the regular schedular standards. In the
absence of such factors, further development for
consideration of an extra-schedular evaluation pursuant to
38 C.F.R. § 3.321(b)(1) is not warranted. Bagwell v. Brown,
9 Vet.App. 157, 158-59 (1996); Shipwash v. Brown, 8 Vet.App.
218, 227 (1995).
In conclusion, the Board holds that the preponderance of the
evidence is against the veteran's claim for an evaluation in
excess of 10 percent for his plantar wart disability. In
reaching this decision, the Board has considered the doctrine
of reasonable doubt. However, a preponderance of the
evidence is against the veteran's claim and the doctrine is
not applicable in this case. Gilbert v. Derwinski, 1
Vet.App. 49, 55-56 (1990).
ORDER
An evaluation in excess of 10 percent for a plantar wart of
the right foot is denied.
CHARLES E. HOGEBOOM
Member, Board of Veterans' Appeals